Personalized Medicine: Major steps on the way

by Dr. Bertalan Meskó on September 20, 2007

You know well, I try to keep you up-do-date about all the improvements and discussions of personalized medicine/genetics. It’s not so easy as I expected as there are more and more articles written on this topic, but just a few of them have really interesting or useful information. This series of posts can turn out to be a blog carnival anyway…

Medco’s Epstein said the next highly anticipated FDA action related to personalized medicine may concern the use of CYP2D6 testing in prescribing tamoxifen, which can help prevent a recurrence of breast cancer after initial treatment.

A nice article at Gene Expression about the Venter genome and it’s ethical issues. We must agree with it, we still know nothing:

Finally, the “personalized medicine” portion of the paper is weak. This is largely due to the fact that not much is known about the genetics of medically-relevant traits, but the authors simply provide a list of alleles known to play a role in phenotypes, and Venter’s genotype at that position. There’s not much more that can be done at this point, but still, it’s not particularly of interest (unless you want confirmation that Venter indeed has blue eyes, as predicted by his OCA2 genotype).

Last time, I told you FDA had suggested that two genetic markers be used to determine the minimal starting dose of Coumadin. Well, here is the method:

One-third of patients receiving warfarin metabolize it quite differently than expected and experience a higher risk of bleeding. Research has shown that some of the unexpected response to warfarin depends on variants of two genes, CYP2C9 and VKORC1. The Nanosphere Verigene Warfarin Metabolism Nucleic Acid Test detects some variants of both genes.

“The potential is huge – for protecting health, for preventing and pre-empting disease and for personalizing treatment according to each person’s unique biology.”

The HHS report describes personalized health care as “a system in which doctors, pharmacists and other health care providers customize treatment and management plans for individuals. It will be founded upon vast amounts of information that will be readily accessible at clinics and hospital bedsides.”

This is not only an opening but a widening of the gates towards a better effect of medical therapeutics in human lives. As long as the practical expanse of genetics abides by ethics respecting patients privacy issues instead of potential abuse of information by those with unfair agenda. The infancy stages are very important in laying the foundation for its potential to have big and better effects.